| National Provider Identifier [NPI]: | 1306192729 |
| Last Name Of The Provider | CURNUTT |
| First Name Of The Provider | JACLYN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | APN |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1423 N JEFFERSON |
| Street Address 2 Of The Provider | #B100 |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 658021917 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 288 |
| Number Of Medicare Beneficiaries | 68 |
| Total Submitted Charge Amount | 19591 |
| Total Medicare Allowed Amount | 9604.96 |
| Total Medicare Payment Amount | 6468.93 |
| Total Medicare Standardized Payment Amount | 8421.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 35 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 729 |
| Total Drug Medicare AllowedAmount | 305.78 |
| Total Drug Medicare PaymentAmount | 296.11 |
| Total Drug Medicare Standardized Payment Amount | 296.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 20 |
| Number Of Medical Services | 253 |
| Number Of Medicare Beneficiaries With Medical Services | 68 |
| Total Medical Submitted Charge Amount | 18862 |
| Total Medical Medicare Allowed Amount | 9299.18 |
| Total Medical Medicare Payment Amount | 6172.82 |
| Total Medical Medicare Standardized Payment Amount | 8125.59 |
| Average Age Of Beneficiaries | 53 |
| Number Of Beneficiaries Age Less65 | 49 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 47 |
| Number Of Male Beneficiaries | 21 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 19 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 49 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 56 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 28 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2813 |